1-800-227-2669 | 316-265-6284 | 1400 E Douglas Ave, Wichita, KS 67214

Tax Exemption

Tax Exemptionht-admin2022-06-06T10:44:42-05:00

Poorman Auto Supply Tax Exemption

PLEASE COMPLETE THE FORM BELOW OR DOWNLOAD THE PDF AND RETURN WITH YOUR REMITTANCE.

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Name of Purchaser*

Address of Purchaser*

Street Address Address Line 2 City State ZIP Code

Registration No.*

I am engaged in the business of selling...*

Name or Seller*

Address of Seller*

Street Address Address Line 2 City State ZIP Code

Description of property to be purchased*

Signature*

Date*

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